Active NPI
Tamekia Pough, OT
- Occupational Therapy Assistant
- Fort Riley, KS
National Provider Identifier
1568758480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- TA1999
- Practice address
- 23804 Eagle Pass Rd
Apt 2
Fort Riley, KS 66442-2669 - Phone
- (601) 543-5370
- NPI assigned
- Jun 20, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | T-04056 | KS | |
| Occupational Therapy Assistant | 224Z00000X | TA1999 | MS | Primary |
Addresses
Primary practice location
23804 Eagle Pass Rd
Apt 2
Fort Riley, KS 66442-2669
Mailing address
23804 Eagle Pass Rd
Apt 2
Fort Riley, KS 66442-2669
Phone (601) 543-5370
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TA1999 | MS | MD | Occupational Therapy Assistant |
| T-04056 | KS | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422835200000",
"number": "1568758480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23804 EAGLE PASS RD",
"address_2": "APT 2",
"city": "FORT RILEY",
"state": "KS",
"postal_code": "664422669",
"telephone_number": "601-543-5370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23804 EAGLE PASS RD",
"address_2": "APT 2",
"city": "FORT RILEY",
"state": "KS",
"postal_code": "664422669",
"telephone_number": "601-543-5370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POUGH",
"first_name": "TAMEKIA",
"name_prefix": "Mrs.",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-06-20",
"last_updated": "2015-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "KS",
"license": "T-04056",
"primary": false
},
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "MS",
"license": "TA1999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Riley, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.